Fractures of the upper third of the face are uncommon but often serious because of associated brain injury. These fractures most commonly resulted from automobile accidents (72%) but the incidence from motorcycle accidents has been increasing in recent years. The mechanism of injury is discussed.

Of 36 patients treated by the author, two died of associated brain trauma. The compressible, air filled, energy absorbing facial bones serve as a decelerating device and protection to those vital structures which lie within and behind them. For this reason, extensive crush type injuries of the upper face can sometimes be seen with little apparent damage to the brain or eyes. Such cases challange the plastic surgeon's ability to reconstruct for both form and function.

The author has developed and described unique surgical techniques for reduction and fixation of various forms of glabellar and supraorbital fractures. Further, he describes procedures and indications for the use of bone grafts and alloplastic implants for the reconstruction of secondary and residual deformities. Statistical references are made regarding the incidence of various types of upper face fractures and the forms of treatment indicated.